Comparison Of Different Model Of Community Health Services In Guangdong Province

After years of development, a relatively complete network system ofCommunity Health Services (CHS) in Guangdong Province has been preliminarilyestablished.Around the actual situation and characteristics, different organizationalmodel of CHS institutions have been set up.Through the investigation of four kinds ofdifferent organizational models of CHS centers in GuangZhou,we can understandtheir current situation and analyze the advantages and disadvantages and find theproblems and deficiencies in the course of operation, also explore the prospects foreach organizational models of CHS.In addition, due to the imbalance of economicdevelopment and the governments attach different importance, Guangdong Provinceis facing unbalanced regional development of CHS.We hope that summarize thedifficulties and problems in underdeveloped areas by comparing the CHS’s status quobetween economically less developed areas and economically developed areas(Guangzhou as a reference), and raise useful suggestions for the development of CHSin economically underdeveloped areas in Guangdong Province based on its owncharacteristics.MethodsDocument analysis: Through professional organizations and journals, monographs, relevant policies and regulations and the investigation reports at homeand abroad on the CHS organizational models, to understand the current situation andthe problems and their advantages and disadvantages of the different organizationalmodel of CHS institutions.At the same time, understand the internal and externalenvironment of CHS development in underdeveloped areas.Questionnaire: Through literature review and expert interviews, designquestionnaires on the CHS centers’ operations, staffs’satisfaction and views as well aspatients’ utilization and awareness of CHS centers. And conduct reasonablemodifications and adjustments after a pre-survey which can test their reasonablenessand practicability.Site visits: Study the CHS centers’ environment for medical treatment, thedepartment settings and actual operations.Depth interviews: Conducted face-to-face personal interviews with the relevantpersons in charge of CHS centers and some medical staff to understand the front-linestaff’s views on the current CHS model, and study their views and suggestions on theproblems.Results(1)Comparison among four organizational models in Guangzhou①The treatment population of University CHS has particularityThe patients of University CHS have significant differences from patients ofother three modes.They are the most younger, the highest degree of culture, thehighest per capita monthly household income, students accounted for a largeproportion.And their high levels of cholesterol/hyperlipidemia report rate is higherthan the patients of the other three modes also.②Patients’ Utilization and awareness of CHS centersThe patients of four organizational models CHS in Guangzhou use servicesmainly are: acute and chronic treatment, prescribe medication, counseling, physicalexamination and follow-up treatment. The patients of University CHS have higherutilization rate on acute treatment and prescribing utilization and have lowerutilization rate on chronic disease diagnosis and treatment and advice. Private mode has the highest proportion of whose patients put CHS institutions as the preferredtreatment agencies, it also has the highest fixed attendance rate (95.5%).(2)Comparison between economically underdeveloped areas with Guangzhou①The CHS staff’s job satisfaction and stabilityThe survey shows that the staff in economically underdeveloped areas has lowerjob satisfaction in various aspects of the work and worse job stability than staff inGuangzhou. Those who occasionally or frequently have the idea to leave the agencyaccount79.5%,and the main reasons for the idea include the low level of income(79.5%), lack of further studies (46.7%) and low social status (37.9%).②Patients’ Utilization and awareness of CHS centersThe first two treatment purpose of patients in Guangzhou are acute and chronicdiseases treatment (71.4%) and prescribe medication (18.4%).80.1%of them putCHS institutions as first choice. The fixed attendance rate is86.4%.While the firsttwo treatment purpose of patients in economically underdeveloped areas arevaccination (44.2%) and acute and chronic diseases treatment (34.0%).37.4%ofthem put CHS institutions as first choice and the fixed attendance rate is45.9%.Asfor the awareness of CHS items, the average number of awareness items of patients inGuangzhou was7.55±3.27, while the average number of awareness items of patientsin economically underdeveloped areas was3.87±3.51.Conclusion(1)Four organizational models of CHS institutions should play to their strengthsand compensate for the disadvantages. These can not be separated from theGovernment’s attention, policies support and community involvement. They shouldintroduce a fair competition mechanism and improve the compensation mechanism,complete medical insurance system and essential drugs system, coordinate with thehospital about two-way referral and strengthen the communication and coordinationwith the streets government, improve the internal operating mechanism and servicequality, expand the breadth and depth of CHS to fully promote development ofdifferent organizational model of CHS institutions.(2)There are many problems of CHS in economically underdevelopedareas,mainly including: service items are incomplete due to inadequate funding of CHS centers; shortage of human resources especially highly qualified personnel;community staff have poor satisfaction and poor stability, as well as lack ofcommunity health promotion resulting low utilization and awareness rate of residents.So corresponding measures should be taken in the future to ensure the sounddevelopment of CHS. Such as: increase financial investment; formulate preferentialpolicies to attract the appropriate medical personnel into the community; give dueconsideration to improve the treatment of medical staff in the community and tostrengthen the publicity of the CHS.